The Evolution of Fibromyalgia, Its Concepts, and Criteria

Abstract

Fibromyalgia developed in the 1950s from a substrate of difficult to explain regional and widespread pain mixed with symptoms of psychosocial distress. Controversies regarding psychological issues were common. Multiple criteria arose to define the disorder, but each identified a different set of patients. The identification of widespread pain as a criterion changed the nature of the disorder by effectively eliminating regional pain as a component condition. The easy-to-measure and relatively reliable widespread pain criterion then came to define the disorder. In the primary care community, diagnostic criteria were largely ignored, and a substantial fraction of diagnosed patients with lower pain scores, particularly women and those with high non-pain symptom scores, were diagnosed. Non-pain symptoms were added back to the fibromyalgia definition and criteria in 2010. Recognition grew that fibromyalgia fit the description of a functional somatic disorder. The idea of fibromyalgia as a primary pain disorder with a neurobiological basis contended with fibromyalgia as a broader biopsychosocial disorder. It is increasingly recognized that fibromyalgia represents a dimensional, non-binary condition and that features of fibromyalgia extend to persons who do not satisfy the criteria. Severity assessments are now available but rarely used. The course of fibromyalgia is not well studied, and improvement and remission criteria have not been successfully defined. The future of fibromyalgia as a discrete disorder remains uncertain as features of fibromyalgia are increasingly observed in patients with multiple different medical conditions.

Reply

“…Furthermore, one question arises: What is the difference between persons with PSD scores of 10 and those with PSD scores of 12? It has been shown that persons who do not meet FM criteria but have mild (scores 4-7) and moderate (scores 8-11) PSD scores have substantial symptomatic burdens and an increase in adverse outcomes (6). Therefore, it appears that diagnosing this condition at the lower severity score is not a weak point of our study, but rather, it indicates that we should not delimit FM diagnosis to scores used in the existing criteria.…”

Research Trends of Acupuncture Therapy on Fibromyalgia from 2000 to 2021: A Bibliometric Analysis

“…Researchers still do not recommend first-line drug treatment but have gradually begun to recognize the role played by alternative medicines in treatment, such as acupuncture. In recent years, Sarzi-Puttini, 47 Wolfe, 48 Maffei, 49 and Galvez-Sánchez 50 have published their opinions and relevant research results on the revision of diagnostic and therapeutic criteria for FMS, and researchers believe that a combination of protocols should be used to develop individualized treatment. The burst intensity of melanoma and core needle biopsy is second only to the criteria, demonstrating that accompanying symptoms related to FMS, such as, tumors, also have the potential to become a hot spot for new research in recent years.…”

Gradual Strength Training Improves Sleep Quality, Physical Function and Pain in Women with Fibromyalgia

“…The pathogenesis of FM continues to be debated. However, it has been demonstrated that fibromyalgia is independent of its comorbidities and FM patients suffer from other pathologies in parallel [ 7 , 8 ]. In the same way, some researchers consider FM to be a neurobiological disease caused by abnormal pain processing [ 9 ].…”